Public Health Sciences
Health or Mortality Disparities: Assessing their associations with cumulative smoke exposure
Bruce Leistikow, MD, MS

Description:
Locate published data then graph, analyze, and present smoke exposure/outcome associations. Uses existing www database or publication data with lung cancer and other health outcome rates by gender, race, place (cities to nations), time, job, income, education, immigration, or other disparity of interest to the student.

Duration: Part or full-time 1 to 6+ months depending on student intentions to a) be very comprehensive or b) publish in journals.

Several references for the medical students to read to determine if they might be interested in the project:

The first 2 papers highlight the almost perfect continuing association between smoke exposure and cancer mortality disparities across time and place in Black males. In other words, when smoking's effects are fully accounted for, nothing else matters much it seems. Our present work assesses those associations in other groups and strata. It appears that treatment is equally ineffective for lung, other deadly cancers, and possibly other outcomes in Black and likely other males and many female group-outcome combinations.

Leistikow BN, Tsodikov A. Cancer death epidemics in United States Black males: evaluating courses, causation, and cures. Prev Med. 2005 Aug;41(2):380-5.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15890397&query_hl=3
 Leistikow B. Lung cancer rates as an index of tobacco smoke exposures: validation against black male approximate non-lung cancer death rates, 1969-2000. Prev Med. 2004 May;38(5):511-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15066352&query_hl=3
Ezzati M, Henley SJ, Thun MJ, Lopez AD. Role of smoking in global and regional cardiovascular mortality.
Circulation. 2005 Jul 26;112(4):489-97.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16027251&query_hl=6
Ezzati M, Henley SJ, Lopez AD, Thun MJ. Role of smoking in global and regional cancer epidemiology: current patterns and data needs. Int J Cancer. 2005 Oct 10;116(6):963-71
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15880414&query_hl=6

A letter of invitation to the student(s):

Dear Student:
Thank you for your interest in evaluating and reducing health disparities! Exposure and health outcome data are already available for a wide range of groupings (race, place, profession, incomes, ...) and outcomes (cancer, all cause mortality, ...). You can help organize (sometimes simply downloaded or copied from papers), graph (generally simple excel scatterplots), analyze (often by simple regression), and present/publish your findings locally or beyond. Depending on your outcome (cancer, ...), groupings/populations of interest (gender, race, place local to global, SES, ...), and ultimate objective (publications?) of interest the work can be brief, part or full time for 2+ months, publishable, ... to a life's work.
Please see the papers above. The latter 2 papers show very large albeit likely vastly underestimated burdens from smoke exposure. Many Californians are very privileged to have smoke free lives. The poor, smokers' children, and people outside California often have much higher smoke exposures and disease rates.

Bruce Leistikow, MD, MS
bnleistikow@ucdavis.edu
752-1409